Excerpt from The Ophthalmic Record, Vol. 7: June, 1898

History - The patient says that he has had good eyesight until eighteen months before he applied for treatment, when vision left him in half an hour. It gradually returned, and now he sees better than at that time, but still cannot use his eyes for anything like accurate vision. The central visual acuity was 30 - 2 and Eff respectively; the Ophthalmoscopic record is: both nerves grayish, retinal vessels small, central scotomas for red and green. He was referred to the Nervous Clinic for further examination; but the examinations were nega tive so far as central nervous disease is concerned. There was no history of syphilis or rheumatism. The knee jerks were increased.

I first examined the patient on the 12th of February, 1898, vision at that time in the right eye being Io/cc and in the left eye 20/cc. Both nerves showed general gray-white atrophy; the veins were slightly tortuous and, compared with the arteries, large; the arteries were small, and there was well-marked, though not exaggerated, perivasculitis. Both pupils reacted normally, and there was no paresis of the external ocular muscles. The field of vision was as follows: Marked concentric contraction, especially upon the right side, very decided contraction of the red field and green blindness. In each eye there was a central scotoma extending from somewhat on the nasal side of the fixing point to about twenty degrees beyond it, in which area the appreciation of red and green was entirely lost. There was, however, no scotoma for blue, and no Spots of absolute loss within the relative area.

The patient had nothing in his history which gave any good excuse for this optic nerve atrophy and perivasculitis, except exposure to lead. He smoked two cigars a day, was not a drinking man, had worked steadily at his trade, but not quite recently, had no history of painter's colic, nor had he ever suffered from wrist-drop. There were marked retraction of the gums and gingivitis. Some what uncertainly a blue line appeared to surround the upper incisor and left lower canine tooth. He was placed upon ascending doses of strychnine and nitro-glycerine, as he had previously taken large doses of iodide of potassium. At the end of two weeks he returned, his vision, if anything, somewhat less accurate than at the first time, namely: o.d., Io/cc.; o.s., 20/cc. Again, at the end of two weeks there was some depreciation of central vision, namely, in the right eye 4/cc, and in the left eye Ig/cc. Examination of the urine failed to reveal albumin or sugar. The tests for lead, however, it was not possible to make at that time. He had carefully brushed his teeth and kept his gums in good order, so that the gingivitis had largely subsided, and still a blue line appeared, somewhat doubtfully, around the incisor and canine.

About the Publisher

Forgotten Books publishes hundreds of thousands of rare and classic books. Find more at www.forgottenbooks.com

This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works.